How much rates vary
Facilitymedian $955 · 10th to 90th $219 to $6,918Professionalmedian $339 · 10th to 90th $234 to $513
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $218.78 Median $363.08 Typical High $741.31 | Facility | None | $218.78 | $363.08 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $588.84 | Professional | None | $218.78 | $346.74 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $257.04 Typical High $588.84 | Professional | None | $128.82 | $257.04 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $436.52 | Professional | None | $234.42 | $316.23 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $549.54 | Facility | None | $234.42 | $331.13 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $524.81 | Professional | None | $281.84 | $371.54 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $380.19 Typical High $1,862.09 | Facility | None | $245.47 | $380.19 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $1,995.26 | Professional | None | $239.88 | $389.05 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $70.79 Median $186.21 Typical High $1,148.15 | Facility | None | $70.79 | $186.21 | $1,148.15 |
United Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $575.44 | Professional | None | $263.03 | $371.54 | $575.44 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $109.65 Median $173.78 Typical High $194.98 | Facility | 52 · Reduced service | $109.65 | $173.78 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $43.65 Median $69.18 Typical High $77.62 | Facility | 53 · Discontinued | $43.65 | $69.18 | $77.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $257.04 Typical High $295.12 | Facility | 54 · Surgery only | $162.18 | $257.04 | $295.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $51.29 Typical High $58.88 | Facility | 55 · Aftercare only | $32.36 | $51.29 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.88 Median $34.67 Typical High $38.90 | Facility | 56 · Pre-op care only | $21.88 | $34.67 | $38.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $239.88 Typical High $275.42 | Facility | 78 · Unplanned return to OR | $151.36 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $109.65 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $257.04 Typical High $295.12 | Professional | 54 · Surgery only | $162.18 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $32.36 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $239.88 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $151.36 | $239.88 | $275.42 |
Where Kentucky sits
The same service costs 3.2 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kentucky· 47th of 51
$347
AK $1,047FL $324
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.